title: An exploratory study of respiratory quotient calibration and association with postmenopausal breast cancer.
abstract: BACKGROUND
  The respiratory quotient (RQ), defined as the ratio of carbon dioxide exhaled to oxygen uptake, reflects substrate utilization when energy is expended. Fat and alcohol have RQ values of approximately 0.7, compared with 1.0 for carbohydrate, and approximately 0.8 for protein. Here, the association between RQ and postmenopausal breast cancer risk is studied.
  
  
  METHODS
  Paired RQ measurements were obtained, separated by approximately 6 months, for women in the reliability subset of a Women's Health Initiative (WHI) Nutrition and Physical Activity Assessment Study. Linear regression of the average of the paired log RQ assessments on a corresponding log food quotient (FQ) average and other study subject characteristics, including age, body mass index, race, and education, yielded calibration equations for predicting RQ.
  
  
  RESULTS
  Calibration equations, using any of food frequency, food record, or dietary recall data, explained an appreciable fraction of measured log RQ variation, and these were used to compute calibrated RQ estimates throughout WHI cohorts. Calibrated RQ estimates using 4-day food record (4DFR) data related inversely (P = 0.004) to (invasive) breast cancer risk in the WHI Dietary Modification trial comparison group, and corresponding RQ estimates using food-frequency data related inversely (P = 0.002) to breast cancer incidence in this cohort combined with the larger WHI observational study.
  
  
  CONCLUSIONS
  Although preliminary, these analyses suggest a substantially higher postmenopausal breast cancer risk among women having relatively low RQ.
  
  
  CONCLUSIONS
  RQ elevation could provide a novel target for breast cancer risk reduction.
authors.affiliation: Authors' Affiliations: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; Division of Health Promotion Sciences, Zuckerman College of Public Health, University of Arizona, Tucson, Arizona; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York; Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, Tennessee; and Department of Public Health Sciences, University of California, Davis, California.
authors.forename: Ross L
authors.initials: RL
authors.lastname: Prentice
authors.forename: Marian L
authors.initials: ML
authors.lastname: Neuhouser
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Tinker
authors.forename: Mary
authors.initials: M
authors.lastname: Pettinger
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: Thomson
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Mossavar-Rahmani
authors.forename: Fridtjof
authors.initials: F
authors.lastname: Thomas
authors.forename: Lihong
authors.initials: L
authors.lastname: Qi
authors.forename: Ying
authors.initials: Y
authors.lastname: Huang
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D001481:Basal Metabolism; D001943:Breast Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D002138:Calibration; D002245:Carbon Dioxide / Q000378:metabolism; D015331:Cohort Studies; D004041:Dietary Fats / Q000008:administration & dosage; D010100:Oxygen / Q000378:metabolism; D017698:Postmenopause / Q000378:metabolism; D015203:Reproducibility of Results; D015656:Respiratory Mechanics / Q000502:physiology
chemical_list: D002245:Carbon Dioxide; D004041:Dietary Fats; D010100:Oxygen